Article Impact Level: HIGH Data Quality: STRONG Summary of Circulation, 149(13), 993–1003. https://doi.org/10.1161/CIRCULATIONAHA.123.066604 Dr. Jennifer B. Green et al.
Points
- The study investigated the impact of glucose-lowering medications on cardiovascular outcomes in individuals with type 2 diabetes and low cardiovascular risk.
- 5047 participants were randomly assigned to receive insulin glargine, glimepiride, liraglutide, or sitagliptin in addition to baseline metformin and were followed for a median of 5 years.
- The liraglutide-treated group exhibited a significantly lower risk of major adverse cardiovascular events (MACE-5, MACE-6) and hospitalization for heart failure compared to the other treatment groups combined.
- No statistically significant differences were observed in the cumulative incidence of first MACE-3, MACE-4, MACE-5, MACE-6, or their components, by randomized treatment group.
- The findings suggest that liraglutide treatment may reduce the risk of cardiovascular events in patients with type 2 diabetes and low cardiovascular risk compared to other commonly used glucose-lowering medications.
Summary
The research aimed to investigate the impact of glucose-lowering medications on cardiovascular outcomes in individuals with type 2 diabetes and low cardiovascular risk. The study, conducted as part of the GRADE trial, involved 5047 participants with a mean age of 57.2 years and a low baseline prevalence of cardiovascular disease. Over a median follow-up period of 5 years, the participants were randomly assigned to receive insulin glargine, glimepiride, liraglutide, or sitagliptin in addition to baseline metformin. The prespecified outcomes included major adverse cardiovascular events (MACE-3, MACE-4, MACE-5, and MACE-6) and hospitalization for heart failure. The results indicated that the liraglutide-treated group exhibited a significantly lower risk of MACE-5, MACE-6, and hospitalization for heart failure compared to the combined treatment groups.
Specifically, the study found no statistically significant differences in the cumulative incidence of first MACE-3, MACE-4, MACE-5, MACE-6, or their components by randomized treatment group. However, the liraglutide-treated group demonstrated a significantly lower risk of MACE-5, MACE-6, and hospitalization for heart failure compared to the other treatment groups combined. Additionally, higher rates of recurrent MACE-6 events were observed in the groups treated with glimepiride or sitagliptin compared to the liraglutide group. These findings suggest that liraglutide treatment may reduce the risk of cardiovascular events in patients with type 2 diabetes and low cardiovascular risk compared to other commonly used glucose-lowering medications.
In summary, the comparative effectiveness study of a contemporary cohort of adults with type 2 diabetes, mainly without established cardiovascular disease, provides valuable insights into the potential cardiovascular benefits of liraglutide treatment in patients at relatively low risk, highlighting its favorable impact on cardiovascular outcomes in this population.
Link to the article: https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.123.066604
References Green, J. B., Everett, B. M., Ghosh, A., Younes, N., Krause-Steinrauf, H., Barzilay, J., Desouza, C., Inzucchi, S. E., Pokharel, Y., Schade, D., Scrymgeour, A., Tan, M. H., Utzschneider, K. M., Mudaliar, S., Crandall, J. P., McKee, M. D., Behringer-Massera, S., Brown-Friday, J., Xhori, E., … Turchin, A. (2024). Cardiovascular Outcomes in GRADE (Glycemia Reduction Approaches in Type 2 Diabetes: A Comparative Effectiveness Study). Circulation, 149(13), 993–1003. https://doi.org/10.1161/CIRCULATIONAHA.123.066604
